        <div>
          <form id="dump_form" target="_blank" action="<?php echo url_for('corporateindividual/datadump') ?>" method="POST">
            <p>
              <label>From:</label>
              <input type="text" id="date_from" name="date_from" />&nbsp;
              <label>To:</label>
              <input type="text" id="date_to" name="date_to" />
            </p>
            <p>
              <label>Reference Number:</label>
              <input type="text" id="ref_number" name="ref_number" value="" />
            </p>
            <?php if($type == 'corporateindividual'): ?>
            <p>
              <label>First Name:</label>
              <input type="text" id="first_name" name="first_name" value="" />&nbsp;
              <label>Last Name:</label>
              <input type="text" id="last_name" name="last_name" />
            </p>
            <?php elseif($type == 'corporatemanaged'): ?>
            <p>
              <label>Company Name:</label>
              <input type="text" id="company_name" name="company_name" value="" />&nbsp;
              <label>Authorized Corporate/Officer Signatory:</label>
              <input type="text" id="authorized_corporate_officer_signatory" name="authorized_corporate_officer_signatory" />&nbsp;
            </p>
            <?php endif; ?>
            <p>
              <label>Status:</label>
              <select id="status" name="status">
                <option value="">Any</option>
                <option value="Completion">Completion</option>
                <option value="Processing">Processing</option>
                <option value="Activated">Activated</option>
              </select>
            </p>
            <p>
              <input type="button" id="filter_button" class="blue" value="Filter" />
              <input type="submit" class="blue" value="Dump" />
            </p>
          </form>
        </div>
        <hr />